Alteraciones motoras del esófago

Abstract

Our understanding of oesophageal motility disorders has grown significantly in this millennium with the emergence and widespread implementation of high-resolution manometry. This technique is highly effective in characterising the topography of pressure and morphology, both of the contractile activity of the oesophageal body and the oesophagogastric junction (OGJ). Through the use of this technique, motility disorders have been recognised that progress with OGJ outflow obstruction (achalasia and OGJ outflow obstruction), hypercontractility disorders (distal oesophageal spasm and hypercontractile oesophagus) and hypocontractility disorders (absent contractility) of oesophageal peristalsis. These disorders present clinically in the form of dysphagia and/or chest pain associated with swallowing. The diagnosis initially requires the ruling out of organic causes (e.g., cancer, peptic stricture, eosinophilic oesophagitis), followed by the characterisation of the disorders using high-resolution manometry. The treatment for oesophageal motility disorders is mainly based on reducing the baseline pressure of the OGJ through pneumatic dilation or endoscopic or surgical myotomy and less frequently through the use of drugs and the local injection of botulinum toxin.